Several games (Cyberpunk, for one) have an effect like cyberpsychosis (defined here as "a psychotic aberration suffered by excessive users of cyberware"). Others, such as Eclipse Phase, consider augmentation a natural state of being for humans.

Are there any reasons why cybernetics/augmentations would cause psychosis, apart from game balance?

11 Answers
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Well, from a literary standpoint, I'd say it's because the games you mentioned represent specific genres in which the concept of cyber psychosis does or does not fit.

The cyberpunk genre is one in which, despite considerable technological change, human nature is proven again and again to be a nearly-unchangeable constant. This makes for some awesome 'human' stories in which cyber psychosis is both a way of preventing characters from straying too far from the human norm, and as a metaphor for becoming 'increasingly inhuman' as a natural consequnce of refusing to accept the natural limits of being mortal.

The transhumanism genre, of which Eclipse Phase is an example, is by contrast all about exploring the consequences that occur when the what it is to be human is sucessfully altered. As a result, any negative consequnces of augmentations in Eclipse Phase are usually the unforseen consequences of their use, and the effects they have on the relationship between the character and the world.

It does make me wonder about the idea of a dark EP setting where there is a steady creep of cyberpsychosis infecting the populace as a result of repeated augmentation and morph-switching :)
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GaxxApr 16 '12 at 13:08

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@Gaxx: Have you seen the alienation chart of Unknown Armies? Something like that would work quiet well with a human to alien via transhuman scale.
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SardathrionApr 16 '12 at 13:12

Integrating an artificial limb or organ in place of a lost original seems to be, according to the literature (in the "related scientific resources" sense, not in the "fictional accounts" one) prone to cause problems. I haven't dug deep into it, but even skimming the top google finds seems to suggest that organ replacement can (though not necessarily does) have lasting (though not necessarily everlasting), troublesome effects on the psyche. (Which I don't find surprising at all.)

However, I'd say the designers' primary concern was game balance, indeed.

If we look at Gibsonian cyberpunk (which really was the inspiration for CP2013 and subsequently CP2020) then there's something of a core element of the fetishisation of both style and technology (which form key elements of cyberware). This fetishisation might form a more 'realistic' core justification for cyberpsychosis that the raw effects of the cyberware itself.

You could run the justification something along the lines of: those people who are likely to fall into the cultural niche of 'the street' and to take on cyberware with fetishistic intensitity are the sort who are prone to psychosis.

This would have the side effect that it'd be possible for more 'normal' folks to take on useful bits and bobs of cyberware without having to worry about going mad. Or maybe it would affect them in different ways?

I'd argue that there would be two sides to that coin. Psychological and neurological.

The cyberpunk world is a rapidly changing world and people in it are in a constant struggle to keep up. At one point, augmenting yourself seems to be the only plausible way of doing this. Some people overdo this and put themselves in a position that is superior to everyone else, at least in their own perspective. Then begins the superiority complex, the feeling that everyone else is insignificant.

It is also known that the human brain is cross-wired in interesting ways, and loss of body parts can do interesting things in the brain. Many amputees are known to have phantom limbs, a mental representation of the now-nonexistent limb that acts and feels just like the original. Try to override with artificial signals from a cyberlimb and I'm quite sure that you would get a number of weird side effects.

Put these together and you have a nice recipe for cyberpsychosis.

PS. Reading Phantoms in the Brain by V.S. Ramachandran right now. Highly recommended if you want to get a good glimpse of how the brain handles alterations to one's body.

Well, lets take the most relevant part of our existing society and try to extrapolate a little.

Who are the most likely to suffer 'less than optimal' human relations - nerds. You don't need cyberware to know the anti-social nerd who is more at home with his computer than his girlfriend.

So, Gibson's stories revolved around such people, those who were already on the outskirts of society and weren't likely to get better integrated - in fact, by introducing more 'non-human' aspects to their lives, they easily become less human. It's all about how they perceive the world around them and their ability to interact with others, and the fact that they increasingly become more involved with the technology. He expanded this to include other anti-scoial groups by giving them access to their own forms of self-obsessive technology.

Want to see how it works? Watch someone with their iPhone, see how they have little interest in people around them when they're engrossed in it. Now imagine if that iPhone was wired directly into their heads so they got a permanently-on fix.

You can also see it on the internet, how some people don't quite understand that the other comments on forums are typed by real, live people. Hence the flamewars and trolling and general anti-social nastiness you get. They wouldn't act like this if the other person was in front of them, but they happily act like asses when interacting with a computer screen.

So this is how I see the cyberware psychosis - its just more of the detachment felt as we increasingly rely on technology. Eventually the empathy with other people drops so low that the sufferer doesn't recognise others as actual people (a little like how young children can't tell that others exist as individuals, they think they are the only creature in the entire universe). You don't have to start with loner assassins who are already one step away from being a serial killer, but ordinary people who just get slowly sucked into obsessive, anti-social behaviour.

Cyberpunk 2020, Shadowrun, and Eclipse Phase are future dystopias in which cybergear effectively grants superhuman powers. So what's to stop you from loading up on gear? In the first two, the game designers added setting-specific material that directly addresses this: the more cyber you've got, the more unstable and inhuman you become. Eclipse Phase is different in that it's also explicitly a horror game in which the technology is one of the few edges that humans have left.

In all three games, the rules and setting reinforce each other. Without the settings, the game-mechanical reasons that your gear is limited would fall flat.

I don't think there's intrinsically any reason (from a science/science fiction perspective) that cyberware ought to lead to psychosis. After all, as far as the left half of your brain knows, the right half is actually some strange computer sending out a barrage of messages.

But in non-utopian SF settings, there are some decent practical reasons why cyberware may lead to psychosis and other cognitive effects.

First, note that cyberware will involve extensive intervention in the brain. Other major brain-altering events (e.g. certain psychotropic drugs, some fraction of strokes, etc.) do have a fairly high risk of causing psychosis or other health problems. If you want to avoid these sorts of problems, you had better work very, very carefully.

Second, note that e.g. large and greedy corporations want to get products that work just well enough to make them huge profits, not so well that they are flawless. So there would be a bias towards making implants that do not have disastrously bad side-effects, but do have integration problems and quite possibly come with mild brain damage (but at a level that is too low to really notice until you have lots and lots of implants and start developing problems--just like people who have lots and lots of microstrokes). In post-apocalyptic cyberpunk settings, instead of greed you have lost knowledge, lack of resources, and desperation driving you to the same compromise. (And Shadowrun 2 and 3 at least--I'm less familiar with the others including SR4--explicitly recognizes something like that with their low-impact high-cost "deltaware", for instance.)

So, overall, it seems pretty reasonable to me that something like this would happen. I don't think the exact manifestation is always chosen correctly (e.g. the inhuman feeling given by Shadowrun cyberware seems somewhat fanciful technologically, though if you posit that essence/magic is a key component of human cognitive function, it makes some sort of magical if not technological sense). But having the limit there is both technically sensible as well as good for game mechanics.

I'm primarily a Shadowrun player, but also an Eclipse Phase dabbler, I'd say that part of the reason for cyberpsychosis in Shadowrun is the "unnatural" state of being and Essence loss (though this is not necessarily the causality). In addition, cyberpunk tends to be about the consequences of actions, and it almost logically follows that changing your body changes your mind. As for Eclipse Phase, there is no penalty for two reasons; first there's no transgressive element to augmentation as in Shadowrun. Second, if you look at the people in Eclipse Phase, a lot have switched bodies, and the average psychological profile in Eclipse Phase is looking at someone who has potentially been in hundreds of different morphs (though practically they probably haven't), or at least switched bodies once, so cyberware isn't as big a deal.

Of note, however, are a couple things:

Part of my rationale for Shadowrun cyberpsychosis involves Essence, which is in my opinion contrary to the original cyberpunk idea that modifying yourself physically directly alters your mentality when one considers that different grades and types of cyberware are more or less invasive. For instance, Delta-grade bone lacing probably won't turn anyone into a raving sociopath, so it stands to reason that standard bone lacing wouldn't either, even if it pushes their Essence low. That said, Essence reflects the amount of psychological impact that cyberware or other events in a character's life has (though not directly; it's more of a physiologically tied thing as well) so it does make sense that low essence characters might become psychotic.

At the risk of going on a tangent, I'm going to look at cyberzombies in Shadowrun; the spirit of someone with a lot of cyberware (or maybe just a random spirit, there's wonderful amounts of ambiguity) bound to their body by powerful magic, cyberware, and medicine (well, the medicine just keeps the body working). If the loss of Essence is so severe that it rather literally causes death and requires a trip to the metaplane of death to prevent the loss of the poor sap on the operating table, it could stand to reason that cyberpsychosis is the same process (if you will) of the individual, much less distinctively so than an Awakened mage, a low-Essence individual being impacted by the loss of connection to the natural state.

As far as Eclipse Phase, I think there's a number of reasons there aren't major impacts from cyberware there; first there's no Essence system in place, "natural" is whatever your mind is acclimated to at the moment, while Shadowrun had a very overt layer of mind adjusting to natural body. Second, the "basic" packages for cyberware and bioware that every morph in Eclipse Phase but the bioconservatives would run 1-3 Essence as standard Shadowrun equivalents, if we assume the cortical stack is relatively unintrusive, so we just really count mesh inserts (equivalent to a decent commlink + image link + datajack [to simulate the direct neural interface] coming to .4 Essence), effectively Age Rejuvenation, though this doesn't see Essence penalties in 4th Edition, probably a Pollution Tolerance genemod, adding .5 Essence to reach .9, probably a Microgravity adaptation though that's not explicitly stated which would add another .5 essence, but ignoring that we can add Basic Immunity immunizations for several diseases (.1, times however many diseases you want gone; probably like ten or so, but let's say .3 Essence), for 1.2 Essence rather conservatively, and that's for the basic package if we leave out morphs that are engineered explicitly to do things that normal humans absolutely cannot, rather than just being "better" humans. This also assumes that you're not doing stuff outside Shadowrun's rules; cortical stacks, for instance, are not included in my tally. Now, admittedly, EP would probably be using Betaware or better relative to Shadowrun, but there's a lot more stuff on most morphs than I listed here; PC's tend to get more mods, making them easily in cyberpsychosis areas if they do packages like I've seen.

Finally, note that there are Exhumans in Eclipse Phase who are pretty much near cyberpsychosis, so it's not entirely absent.

TV Tropes covers the topic pretty well on the Cybernetics Eat Your Soul page. Competitive balance is called out as the primary rationale for cyberpsychosis, and it is pointed out that:

It's also notable that this trope happened in few (if any) of the
original Cyber Punk novels that inspired most of these games.

And that:

This trope usually accompanies the broken lesson that only cyberware
inflicts humanity loss — sure, getting that Arm Cannon will dehumanize
you, but not deliberately committing actual atrocities, getting hooked
on hard drugs, learning Black Magic, having a mental illness that is
not fictional, or other expected sources of insanity. It is also a
Broken Aesop when Ridiculously Human Robots are depicted as
more...um...human.

The detailed list of tabletop RPGs that address the issue of cyberpsychosis in one way or another (some explicitly reject it) is quite extensive.

Looking back at this after a year, I think this needs a more refined approach than my first one.

Cyberpsychosis comes from the concept that intentionally losing one's humanity is intended as a step to distance oneself from one's "inferior" fleshy brethren.

This leads to three different interpretations in games, sort of inspired by different attitudes; the "you monster", "human but different", and the "so what" schools of thought.

"You Monster"

Look at Syndicate's FPS reboot. Or the very concept of Cyberpsychosis as such. This is a reflection of fears of technology and antisocial behavior. This opinion is motivated by three things (and potentially in different combinations); fear of the machine overtaking the human, fear of the outsider, and fear of the strong oppressing the weak. We see the "You Monster" mindset in Deus Ex with Navarre or Barrett, and very heavily with pretty much every character in the Syndicate reboot-they've become so that they're more than their unaugmented fellows and they aren't afraid to show it, but we can also see this in things like the Terminator reboot, where the protagonist is a human/android hybrid who must fight his hardware to regain his humanity. This mindset puts machine and human as inherently opposed. (Coincidentally, the Syndicate FPS was a game where I felt the protagonist was forced into this role, despite a lack of logic to it, in part due to the fact that it's a cardboard cutout shooter.)

"Human But Different"

This is what we see more in something like Shadowrun; cyborgs lose out on a part of their humanity, but they are still "human" to a degree (at least in the majority of the fluff; where they are no worse than the other characters). Human But Different is also visible in Warhammer 40k, with the Adeptus Mechanicus, and to a smaller extent in much of science-fiction. It's a more modern look at cyborgs that views them as viable for a good chunk of the human population, and as such there is less stigmatization, since the market of people with augmentations includes such people as the future author and readers. This is pretty popular, at least among certain things. It tends to focus on physicality, but views the body as a tool of the mind.

"So What?"

The "So What?" school of thought is transhuman in nature-it focuses on the consciousness of an individual rather than their physicality, and we typically see it more in settings like Eclipse Phase, where people swap between bodies rather than physically travel because it's more convenient to do so. This is somewhat uncommon and cutting edge-but it's seen often in video games such as Deus Ex with protagonists such as JC Denton and Adam Jensen who are basically themselves prior to augmentation but with fancy chrome bits.

Reasons for Cyberpsychosis

Ultimately, Cyberpsychosis as a rule is somewhat based on the opinion one takes-the "You Monster" approach justifies it inherently as an outcome of the cyberware, but something like Vampire the Masquerade's Humanity system would perhaps work better-the latter two schools fall more into the idea that cyberware allows people to do more stuff more efficiently, and it essentially allows them to dehumanize themselves if they so choose-whether for good (transhumans denying their physical and mental weaknesses by switching to a new form) or for evil (a cyborg mowing down everything in his path). Basically, in the second and third schools, cyberpsychosis comes from failure to remember one's connection to fellow man, and the fact that committing an atrocity is one neural signal away.

Shadowrun's a slight exception to this rule, because it does have cyberpsychosis rules in addition to the normal things-these are, however, a result of the loss of Essence, which in its case is in part a magical phenomena as well as a strictly technological one.